DERMATOLOGY ASSOCIATES OF CENTRAL NEW JERSEY, PA
NPI 1104950013
Dermatology - MOHS-Micrographic Surgery in Old Bridge, NJ
About Dermatology Associates Of Central New Jersey, Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DERMATOLOGY ASSOCIATES OF CENTRAL NEW JERSEY, PA (NPI 1104950013) is a healthcare organization registered as a mohs-micrographic surgery in Old Bridge, New Jersey and active in the NPI registry since March 2007. The organization holds a CLIA Certificate of Compliance certificate valid through August 6, 2027 and lists Grace Centurion, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dermatology Associates Of Central New Jersey, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Dermatology Associates Of Central New Jersey, PA, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 31D0947927
Dermatology Associates Of Central Nj · Old Bridge, NJFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Dermatology Associates Of Central New Jersey, PA's NPI number?
The NPI number for Dermatology Associates Of Central New Jersey, PA is 1104950013. It was assigned to this organization in the NPPES registry on March 15, 2007.
Where is Dermatology Associates Of Central New Jersey, PA located?
Dermatology Associates Of Central New Jersey, PA is located at 3548 Route 9 Suite 2, Old Bridge, NJ 08857. The listed phone number is (732) 679-6300.
What is Dermatology Associates Of Central New Jersey, PA's specialty?
The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.
Is Dermatology Associates Of Central New Jersey, PA enrolled in Medicare?
Yes. Dermatology Associates Of Central New Jersey, PA is registered in the Medicare PECOS enrollment system.
When is Dermatology Associates Of Central New Jersey, PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New Jersey, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Dermatology Associates Of Central New Jersey, PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Dermatology Associates Of Central New Jersey, PA, in Dermatology, Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Dermatology Associates Of Central New Jersey, PA hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 31D0947927) is associated with this NPI, valid through August 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Dermatology Associates Of Central New Jersey, PA was last updated on January 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dermatology Associates Of Central New Jersey, Pa · NPI 1104950013
MOHS-Micrographic Surgery organization in Old Bridge, New Jersey. Organization record, active in the CMS NPPES registry since March 15, 2007.
## Identity
- **NPI:** 1104950013 (Entity type: Organization)
- **Enumerated:** March 15, 2007
- **Primary specialty:** Dermatology - MOHS-Micrographic Surgery · taxonomy 207ND0101X
- **Organization subpart:** No
- **Authorized official:** Grace Centurion, OFFICE MANAGER
## Practice location
- **Address:** 3548 ROUTE 9, SUITE 2, Old Bridge, NJ 08857-2765
- **Phone:** (732) 679-6300 · **Fax:** (732) 679-9566
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, New Jersey, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Dermatology (1), Family Practice (1); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 22, 2016
- **Other identifiers:** Medicare UPIN 107968 (NJ); Medicare UPIN C53742 (NJ)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104950013) · Data from the CMS NPPES public registry.